[Reproductive outcome after laparoscopic myomectomy--retrospective analysis 1994-2007]. / Reprodukcní výsledky po laparoskopické myomektomii--retrospektivní analýza 1994-2007.

The aim of the study was to analyse the reproductive outcome after laparoscopic myomectomy (LM) in infertile patients. Between the years 1994-2007 were 351 infertile women operated in our department. The average age of the patients was 33.5. The total number of extirpated fibroids was 643, with the average of 1.7 per patient and the average size of 3.3 cm. 171 women (48.7%) became pregnant after LM. There were 119 deliveries, 16 spontaneous abortions and 6 ectopic pregnancies in this group. The caesarean section (CS) rate was 46.2% . Intramural localisation of the fibroid significantly correlated with the termination of pregnancy by CS. I. and II. trimester pregnancy loss correlated significantly with deep coagulation when conception occurred during 12 months after surgery. No uterine rupture was observed during pregnancy.

Study of the mechanism of the photoisomerization and photooxidation of bilirubin using a model for the phototherapy of hyperbilirubinemia.

Liquid chromatography was employed for a study of photochemical degradation of bilirubin in the complex with human albumin, using a model system in the presence of riboflavin. The concentrations of bilirubin, the photoisomers and biliverdin were monitored. The reaction mechanism was verified using a quantified mathematical model and was represented by a reaction scheme. Photoisomerization is the initial process, followed by photooxidation to degradation products of the tetrapyrrole skeleton, with formation of biliverdin as an intermediate. The blood of newborns that were irradiated for treatment of hyperbilirubinemia was studied for the sake of comparison. The effect of some biochemically important substances was followed, in view of possible inhibition of the processes. The experimental results demonstrate that riboflavin acts as a catalyst, even at the concentrations typical for its occurrence in blood. The results are discussed from the point of view of the mechanism of bilirubin degradation during phototherapy.

When is it possible to meet the wish of a woman to terminate her labour by caesarean section?

The authors have evaluated 311 answers of Czech obstetricians to the questionnaire concerning their attitude towards pregnant women that want to terminate their labour by caesarean section. The questionnaire contained six model situations: (1) normal delivery; (2) previous caesarean section; (3) breech presentation; (4) previous delivery of an injured baby; (5) protracted labour and (6) caesarean section apparently indicated by another obstetrician. In each situation the obstetrician was encouraged to choose from five different answers. The results have revealed the lack of unanimity in some cases, 3, 4 and 5. Here we feel that the obstetrician should meet the wish of the woman. However, in those situations that are clear from the medical point of view and where there is no professional indication for a caesarean section, it is in accordance with the Czechoslovak rule of law not possible to meet the wish of the woman.

[Transcutaneous measurement of the severity of icterus and bilirubinemia in normal neonates]. / Transkutánní merení intenzity ikteru a bilirubinémie fyziologických novorozencu.

Using a Minolta/Air Shields apparatus, the authors made 1040 transcutaneous estimations of the intensity of jaundice and examined at the same time the serum bilirubin in 603 normal mature neonates. They revealed a significant (P less than 0.001) correlation between the results of this estimation on the sternum and bilirubinaemia (r = 0.75). Based on the assessment of the 95% confidence limit of prediction of linear regression the authors defined and confirmed by statistical calculations for bilirubinaemia values of 200, 250 and 300 mumol/l four grades of intensity of jaundice. By the suggested procedure omission of early indication of laboratory examination and phototherapy is reduced to a minimum and conversely it is possible to avoid in some neonates collection of blood samples for laboratory examination.

[Disorders of the menstrual cycle in women after entering military training. IV. FSH, LH, prolactin, estradiol, progesterone and cortisol in the first week after beginning training]. / Poruchy menstruacního cyklu u zen po nástupu do vojenského uciliste. IV. FSH, LH, prolaktin, estradiol, progesteron a kortizol v prvním týdnu po nástupu do uciliste.

The authors investigated the hormonal levels of FSH, LH, oestradiol, cortisol and progesterone in women after entering a military training contre. The specimens were collected on the fourth day after admission to the Centre and the results correlated with later "separation" disorders of the menstrual cycle in these women. The authors did not find differences in the mean levels of any hormone in normally regularly menstruating women and in women with disorders of the cycle. They found, however, a significantly higher variance of LH and oestradiol levels in women with disorders of the cycle. When investigating the correlation of different hormone levels, they found a significant positive correlation of FSH:LH, LH:oestradiol, FSH:oestradiol, prolactin:cortisol, and an indirect correlation of LH:cortisol.

Reproductive outcome in women who lost their husbands in the course of pregnancy.

The loss of a husband in the course of pregnancy represents a serious life event that is accompanied by important psychosocial stress. We compared the length of pregnancy and the weight of the newborns in women who were widowed in the course of their pregnancy with control groups of married and unmarried women of the same parity and delivering in the same institute. The group of widowed parturients consisted of 40 women. The control group of married women included 38 cases, and the control group of unmarried women consisted of 33 cases. The results were statistically evaluated by means of variance analysis and sequential pair t-test. The average length of pregnancy was in the widowed women 279.46 +/- 8.54 days, in married women 277.13 +/- 10.9 days and in unmarried women 273.91 +/- 16.17 days. The differences are not statistically significant. The average weight of the newborn was 3327.0 +/- 484.98 g in the widowed women, 3347.11 +/- 404.76 g in married women and 3068.18 +/- 543.79 g in unmarried women. The weights of the newborns of widowed and married women are not different, but both are significantly higher than in the unmarried women (p less than 0.05). The results do not confirm the influence of psychosocial stress due to life events occurring in the course of pregnancy upon the length of the pregnancy and the weight of the newborn.